I've written about health care for more than two decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary Clinton through the Hawkeye state talking health reform and the economy. I have covered the rise, fall and rise again of health reform, chronicling national trends as well as the influence of Barack and Michelle Obama from Chicago's South Side on changes to the U.S. health system from my base in Chicago. I am the author of the new Forbes signature series book, "Inside Obamacare: The Fix For America's Ailing Health Care System." I was health care business reporter at the Chicago Tribune (1998-2011) and previously wrote for Modern Healthcare magazine when first arriving in Chicago in 1993. Prior to that, I wrote for several Iowa newspapers including the Des Moines Register. These days, I contribute stories to the New York Times, Chicago Medicine magazine and teach in the University of Iowa School of Journalism MA in Strategic Communication program. You can see me nationally on Fox News Channel's "Forbes on Fox" show. In Chicago, you can hear my health segments and business analysis on WBBM newsradio 780 and 105.9 FM. I am passionate about health literacy when it comes to explaining the complexities of health care. A better understood health system may save someone some money or their life.

Health Care Prices Remain A Mystery In Most States

A new report says most states fail when it comes to price transparency in health care. (Photo credit: Franck BLAIS)

As public scrutiny intensifies over price transparency in health care, a new report shows 72 percent of the nation, or 36 states, failing to improve information to consumers on what medical treatments and procedures actually cost.

The report from two business coalitions representing some of the nation’s largest employers is the latest troubling sign that most prices in health care remain a mystery to consumers, employers and patients picking up the tab for health care services. They cite national studies showing prices for identical procedures can vary more than 700 percent in some cases.

“It should be concerning to every lawmaker in the country that 18 percent of the U.S. economy is shrouded in mystery,” said Francois de Brantes, executive director of Health Care Incentives Improvement Institute and report card co-sponsor, the Catalyst for Payment Reform.

“More Americans than ever before are paying a significant percentage of health care costs and they can’t comparison shop without price information,” de Brantes said. “We’ve been all focusing so much on utilization, that we’ve ignored price almost completely. We’re now seeing a convergence of issues highlighting the criticality of price transparency, and state and federal legislators are asleep at the switch. It’s time for a wakeup call and we hope this is it. ”

The report shows only 14 states are achieving a grade of “C” or better when it comes to price transparency, while 72 percent are scoring a “D” or an “F.” The majority of states are providing information about “charges” yet those figures do not reflect what patients, consumers, employers and health plans end up paying for tests, procedures and other medical care services. And when consumers seek pricing information, it is generally only “available on request,” the study said.

“It is only fair and logical to ensure that consumers have the information they need about quality and cost to make informed decisions about where to seek care,” said Suzanne Delbanco, executive director of Catalyst for Payment Reform, a non-profit group that represents large purchasers of health care like AT&T (T), Boeing (BA), E-Bay (EBAY) and Wal-Mart Stores Inc. (WMT).

Just two states — Massachusetts and New Hampshire — received an “A” for sharing an array of price information. Both states, for example, share information about the price of services for both “inpatient and outpatient services” as well as “information for both doctors and hospitals.” In addition, they share data through a public web site or in public reports, allowing consumers to request such information before patients are admitted to a hospital.

“We know from studies that the price for an identical health care procedure performed in the same city can vary by as much as 700 percent, with no difference in quality,” de Brantes said. “When consumers shop for value, they can help rein in health care costs. But to do this, they first need timely and actionable price information.”

The employers and other businesses that are part of the institute and the Catalyst for Payment Reform are advocating for “laws and forthcoming legislation” to “provide powerful motivation to be more transparent,” Delbanco said. “We hope this report card spurs states to act to help consumers further.”

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This is a problem. But as more employers and insurers move toward high deductible plans or what they call consumer-directed plans, doctors and hospitals may be forced to disclose more on price. That could be a good thing if it happens.

Health Care transparent? Congress didn’t even read the bill before they passed it! This is such a travesty of our countries principles. As if the Obama Administration had any transparency. Hard to do, when most of what Obama says is misleading, or totally false.

Health care a mystery?? Mr. Obama had a chance to correct the problems with the health care industry, but he chose instead to not be influenced by the consumer (the voter), but rather by the health care insursance lobby groups. This is no mystery, this should be an outrage.

If health care cost are ever going to be contained, then transparency has to happen. Most healthcare organizations continue to have a secrecy system or gag order on their actual cost. Insurance companies and pharmaceutical companies are part of this. These systems continue to tell us their profit margin is very small but this is hidden behind non profit organization and constant re-investment of funds in competitive “cost”. Knowing where all the money goes is just speculation at best until there really is a transparency in these shielded expenses and profits.

Cosmetic surgery prices were also a secret in the past. But now with www.buildmybod.com you can find a board certified plastic surgeon in your area and get the total cost estimate for a procedure, all before your consultation. No more sticker shock!